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This study aims to address a critical gap in the literature by examining the incorporation of uncertainty in measuring carbon emissions using the greenhouse gas (GHG) Protocol methodology across all three scopes. By comprehensively considering the various dimensions of CO2 emissions within the context of organizational activities, our research contributes significantly to the existing body of knowledge. We address challenges such as data quality issues and a high prevalence of missing values by using information entropy, techniques for order preference by similarity to ideal solution (TOPSIS), and an artificial neural network (ANN) to analyze the contextual variables. Our findings, derived from the data sample of 56 companies across 18 sectors and 13 Brazilian states between 2017 and 2019, reveal that Scope 3 emissions exhibit the highest levels of information entropy. Additionally, we highlight the pivotal role of public policies in enhancing the availability of GHG emissions data, which, in turn, positively impacts policy-making practices. By demonstrating the potential for a virtuous cycle between improved information availability and enhanced policy outcomes, our research underscores the importance of addressing uncertainty in carbon emissions measurement for advancing effective climate change mitigation strategies.

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An analytical method for quantification of seventeen pharmaceuticals and one metabolite was validated and applied in the analysis of hospital effluent samples. Two different sampling strategies were used: seasonal sampling, with 7 samples collected bimonthly; and hourly sampling, with 12 samples collected during 12 h. Thus, the variability was both seasonal and within the same day. High variability was observed in the measured concentrations of the pharmaceuticals and the metabolite. The quantification method, performed using weighted linear regression model, demonstrated results of average concentrations in seasonal samples ranged between 0.19 µgL-1 (carbamazepine) and higher than 61.56 µgL-1 (acetaminophen), while the hourly samples showed average concentrations between 0.07 µgL-1 (diazepam) and higher than 54.91 µgL-1 (acetaminophen). It is described as higher because the maximum concentration of the calibration curve took into account the dilution factor provided by DLLME. The diurnal results showed a trend towards higher concentrations in the first and last hours of sampling. The risk quotient (RQ) was calculated using organisms from three different trophic levels, for all the analytes quantified in the samples. Additionally, in order to understand the level of importance of each RQ, an expert panel was established, with contributions from 23 specialists in the area. The results were analyzed using a hybrid decision-making approach based on a Fuzzy Analytic Hierarchy Process (FAHP) and the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method, in order to rank the compounds by environmental risk priority. The compounds of greatest concern were losartan, acetaminophen, 4-aminoantipyrine, sulfamethoxazole, and metoclopramide. Comparison of the environmental risk priority ranking with the potential human health risk was performed by applying the same multicriteria approach, with the prediction of endpoints using in silico (Q)SAR models. The results obtained suggested that sulfamethoxazole and acetaminophen were the most important analytes to be considered for monitoring.

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Introducción: Son muy escasos los estudios publicados sobre el efecto de infiltraciones con células madres en seudoartrosis aséptica posquirúrgicas. Asimismo, los métodos tradicionales de tratamiento coadyuvante para favorecer la consolidación (esteroides anabólicos y bifosfonatos) representan elevados riesgos, rechazo e incluso abandono del tratamiento por parte del paciente. Objetivo: Jerarquizar las variables más influyentes para el tratamiento con células madre en la seudoartrosis aséptica posquirúrgica en el servicio de Ortopedia y Traumatología del Hospital General Docente "Dr. Agostinho Neto" del municipio de Guantánamo en el período de enero 2022 a enero 2023, con el empleo de la herramienta fuzzy TOPSIS. Método: Se aplicó un estudio descriptivo, con el apoyo de los métodos de proceso de jerarquía analítica difusa (fuzzy AHP) y técnica para el cumplimiento de órdenes por similitud con la solución ideal difusa (fuzzy TOPSIS), con datos del departamento de Ortopedia y Traumatología del hospital antes mencionado. El universo estuvo constituido por 50 pacientes, la muestra del estudio quedó conformada por n ꓿ 44. Resultados: Se pudieron obtener las principales variables que intervienen en un tratamiento con células madre en la seudoartrosis para garantizar el éxito en la implementación de dicho tratamiento, ellas fueron: trazo de la fractura, causa de la seudoartrosis, tipo de terapia empleada, tiempo de consolidación y grado de consolidación. Conclusiones: La jerarquización de las variables obtenidas constituirá una guía donde los servicios de Ortopedia y Traumatología del Hospital General Docente "Dr. Agostinho Neto", del municipio de Guantánamo, podrá incidir en la efectividad del tratamiento con células madre en la seudoartrosis.

Introduction: Currently there are very few published studies concerning the effect of implantations with stem cells in post-surgical aseptic pseudoarthrosis. In addition, the traditional methods of adjuvant treatment in order to improve efficacy (anabolic steroids and bisphosphonates) represent high risks, rejection and even treatment abandonment by patients. Objective: Hierarchalising the most influential variables for treatment with stem cells in post-surgical aseptic pseudoarthrosis in the Orthopedics and Traumatology service of the Hospital General Docente "Dr. Agostinho Neto", Guantánamo, from January 2022 to January 2023, with the application of the TOPSIS fuzzy method. Method: A descriptive study was applied, with the application of Fuzzy Analytical Hierarchy process methods (Fuzzy AHP) and the Technique for Order of Preference by Similarity to Ideal Solution (fuzzy TOPSIS), with information gathered from the Orthopedics and Traumatology department of the aforementioned hospital. The universe of study consisted of 50 patients. The study sample included n꓿44. Results: It was possible to obtain the main variables involved in the stem cell treatment for pseudarthrosis, variables with great contribution in the success of implementation of such treatment, which were as follow: fracture trace, cause of pseudarthrosis, type of therapy used, time of bone consolidation and degree in bone consolidation. Conclusions: The hierarchization of the variables obtained will constitute a guide where the Orthopedics and Traumatology services of the Hospital General Docente "Dr. Agostinho Neto", in Guantánamo municipality, will be able to influence in the efficacy of stem cell treatment for pseudarthrosis.

Introdução: Existem poucos estudos publicados sobre o efeito de infiltrações com células-tronco em pseudoartrose asséptica pós-cirúrgica. Da mesma forma, os métodos tradicionais de tratamento adjuvante para promover a consolidação (esteróides anabolizantes e bisfosfonatos) representam riscos elevados, rejeição e até abandono do tratamento por parte do paciente. Objetivo: Priorizar as variáveis de maior influência para o tratamento com células-tronco na pseudoartrose asséptica pós-cirúrgica no serviço de Ortopedia e Traumatologia do Hospital General Docente "Dr. Agostinho Neto" do município de Guantánamo no período de janeiro de 2022 a janeiro de 2023, com a utilização da ferramenta fuzzy TOPSIS. Método: Foi aplicado um estudo descritivo, com apoio dos métodos de processo hierárquico analítico fuzzy (fuzzy AHP) e da técnica de atendimento de pedidos por similaridade com a solução fuzzy ideal (fuzzy TOPSIS), com dados do Departamento de Ortopedia e Traumatologia do referido hospital. O universo foi constituído por 50 doentes, a amostra do estudo foi constituída por n꓿44. Resultados: Foi possível obter as principais variáveis que intervêm num tratamento com células estaminais na pseudoartrose para garantir o sucesso na implementação do referido tratamento, elas foram eles: linha de fratura, causa da pseudoartrose, tipo de terapia utilizada, tempo de consolidação e grau de consolidação. Conclusões: A hierarquização das variáveis obtidas constituirá um guia onde os serviços de Ortopedia e Traumatologia do Hospital General Docente "Dr. Agostinho Neto", município de Guantánamo, poderá influenciar a eficácia do tratamento com células-tronco na pseudoartrose.

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Brazil's Unified Health System (SUS) provides universal free access to health services and is considered a model for the rest of the world. One of the tools used by the Brazilian government to assess this system is the Index of Unified Health System Performance (IDSUS). However, this method has a number of limitations, such as disregarding the opinion of healthcare decision makers. Thus, the aim of the present study was to propose a model based on the R-TOPSIS in order to assess the performance of the SUS. Methodologically, the main steps for proposing multi-criteria models were followed, and to validate the model, a real case study with a set of six cities (alternatives) of the state of São Paulo was used. The results provide a clearer picture of the differences in terms of potential and obtained access, as well as the effectiveness of health services in the cities analyzed. Likewise, the proposal of integrating multiple criteria as well as considering healthcare decision makers proved to be decisive for the results obtained, even in comparison with the other approaches. It was concluded that the proposed method provides a robust and adequate analysis of health systems performance.

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This study describes the most relevant problems and solutions found in the literature on teaching and learning of object-oriented programming (OOP). The identification of the problem was based on tertiary studies from the IEEE Xplore, Scopus, ACM Digital Library and Science Direct repositories. The problems and solutions identified were ranked through the multi-criteria decision methods DEMATEL and TOPSIS in order to determine the best solutions to the problems found and to apply these results in the academic context. The main contribution of this study was the categorization of OOP problems and solutions, as well as the proposal of strategies to improve the problem. Among the most relevant problems it was found: 1) difficulty in understanding, teaching and implementing object-orientation, 2) difficulties related to understanding classes and 3) difficulty in understanding object-oriented relationships. After doing the multicriteria analysis, it was found that the most important solutions to face the problems found in the teaching of OOP were: 1) use of active learning techniques and intrinsic rewards and 2) emphasize on basic programming concepts and introduce the object-oriented paradigm at an early point in the curriculum. As a conclusion, it was evidenced that there is coherence between the literary guarantee that gives support to the problems and solutions in the teaching of OOP presented in this study and the approaches that experts in the area of development highlight as relevant when they identify weaknesses in the process.

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The classifier selection problem in Assistive Technology Adoption refers to selecting the classification algorithms that have the best performance in predicting the adoption of technology, and is often addressed through measuring different single performance indicators. Satisfactory classifier selection can help in reducing time and costs involved in the technology adoption process. As there are multiple criteria from different domains and several candidate classification algorithms, the classifier selection process is now a problem that can be addressed using Multiple-Criteria Decision-Making (MCDM) methods. This paper proposes a novel approach to address the classifier selection problem by integrating Intuitionistic Fuzzy Sets (IFS), Decision Making Trial and Evaluation Laboratory (DEMATEL), and the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS). The step-by-step procedure behind this application is as follows. First, IF-DEMATEL was used for estimating the criteria and sub-criteria weights considering uncertainty. This method was also employed to evaluate the interrelations among classifier selection criteria. Finally, a modified TOPSIS was applied to generate an overall suitability index per classifier so that the most effective ones can be selected. The proposed approach was validated using a real-world case study concerning the adoption of a mobile-based reminding solution by People with Dementia (PwD). The outputs allow public health managers to accurately identify whether PwD can adopt an assistive technology which results in (i) reduced cost overruns due to wrong classification, (ii) improved quality of life of adopters, and (iii) rapid deployment of intervention alternatives for non-adopters.

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Contaminants of emerging concern (CECs) have been a focus of study for years, with investigations revealing the contamination of different environmental matrices (surface water, soil, air, and sediment) by diverse classes of microcontaminants. Understanding the contamination profiles requires identification and risk assessment of the microcontaminants. In the present work, analysis was made of the presence of 3250 compounds in 27 samples from the Conceição River (Rio Grande do Sul State, Brazil), using an SPE-LC-QTOF MS method. In total, 150 microcontaminants (confirmed and suspected) of different classes, especially pesticides and pharmaceuticals, were identified by an initial qualitative analysis. Subsequently, in silico predictions of eight endpoints, using quantitative structure-activity relationship ((Q)SAR) models, were employed to determine the risk of each previously screened microcontaminant. This large amount of (Q)SAR data, frequently with conflicting information in relation to the responses of the different endpoints, makes it difficult to define which microcontaminants should be prioritized for analysis. Therefore, in order to rank the identified microcontaminants by risk assessment, two multi-criteria decision-making (MCDM) ranking techniques (ToxPi and TOPSIS), associated with a weighting method, were performed to establish the order of priority for further quantitative analysis of the most hazardous microcontaminants. The two rankings were statistically similar, especially for the 20 highest priority microcontaminants. Nonetheless, sensitivity tests carried out for the ToxPi and TOPSIS outputs showed higher performance robustness of TOPSIS, compared to ToxPi. This is the first time that such an approach (screening/(Q)SAR/MCDM methods) has been performed in the context of microcontaminant environmental risk evaluation and demonstrated to be an available strategy to help rank the most concern microcontaminants identified in aqueous environment samples.

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RESUMO A crescente demanda e a diminuição da disponibilidade de água com qualidade devido à degradação constituem um desafio para os gestores dos recursos hídricos. As águas subterrâneas são recursos hídricos importantes que, em geral, apresentam boa qualidade. Porém, a elevação da contaminação das águas subterrâneas, causada principalmente por atividades antropogênicas e uso do solo, coloca em risco a segurança hídrica. A avaliação dos recursos hídricos subterrâneos e as decisões tomadas para proteção contra a degradação fazem parte de um processo complexo. A avaliação de áreas vulneráveis ao risco de contaminação é uma análise essencial para o planejamento e gestão. Neste estudo, utilizou-se metodologia multicritério para proposição de um modelo de avaliação da vulnerabilidade ao risco de contaminação por meio de informações de poços que fornecem água para o abastecimento público, destacando-se as áreas mais impactadas pela ação antropogênica. Doze poços foram avaliados quanto aos critérios: índice GOD, nitrato, potencial hidrogeniônico, sólidos totais dissolvidos e coliformes totais. A aplicação do método de multicritério AHP e TOPSIS resultou na ordenação dos poços que estão mais vulneráveis e que necessitam de medidas de proteção e controle de degradação. Os poços que são considerados mais vulneráveis estão localizados em meio urbano; assim, pode-se inferir que estão sendo degradados por efluentes lançados no solo sem o devido tratamento.

ABSTRACT The growing demand and the declining availability of quality water due to degradation are a challenge for water resource managers. Groundwater is a vital water resource that is generally of good quality. However, with the increase of contamination caused mainly by anthropogenic activities, water safety is put at risk. The assessment in groundwater resources and decision-making to protect against degradation is a complex process. Assessing areas vulnerable to contamination risk is an essential analysis for planning and management. In this study, we used the multi-criteria methodology to propose a model for assessing vulnerability to contamination risk through information from wells that provide water for public supply, highlighting the areas most impacted by anthropogenic action. Twelve wells were evaluated under the following criteria: GOD index, nitrate, hydrogen potential, total dissolved solids, and total coliforms. The application of the AHP and TOPSIS multi-criteria methods resulted in the ordering of the wells that are most vulnerable and that need protection and degradation control measures. The wells that are considered more vulnerable are located in urban areas, so it can be inferred that they are being degraded by activities by effluents released into the soil without proper treatment.

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In the last decades, there has been an increase in impacts on the environment, driven by the industrialization process. As a result, society's social and environmental awareness increased, and business organizations began to promote corporate social responsibility initiatives to positively contribute to better working and environmental conditions, and other sustainability issues. This article aims to verify the performance of 217 Brazilian municipalities from 31 indicators segmented in the three dimensions of sustainability (economic, environmental, and social), selected from the literature review, to contribute to the sustainable investment strategy of organizations. To this end, we used the multi-criteria decision making method, Technique for Order Preference by Similarity to Ideal Solution (TOPSIS), and proposed an analytical sustainability dashboard. The main results of this paper were the sustainable performance rankings of the municipalities and the dashboard with three analytical panels that contributed to identifying the points of improvement of each municipality, consequently contributing to the investment strategy in these locations. This research consists, therefore, of an important methodology, combining the multi-criteria method and the sustainability dashboard, to assess the sustainable development of the municipalities in the triple bottom line dimensions.

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Considering the unexpected emergence of natural and man-made disasters over the world and Turkey, the importance of preparedness of hospitals, which are the first reference points for people to get healthcare services, becomes clear. Determining the level of disaster preparedness of hospitals is an important and necessary issue. This is because identifying hospitals with low level of preparedness is crucial for disaster preparedness planning. In this study, a hybrid fuzzy decision making model was proposed to evaluate the disaster preparedness of hospitals. This model was developed using fuzzy analytic hierarchy process (FAHP)-fuzzy decision making trial and evaluation laboratory (FDEMATEL)-technique for order preference by similarity to ideal solutions (TOPSIS) techniques and aimed to determine a ranking for hospital disaster preparedness. FAHP is used to determine weights of six main criteria (including hospital buildings, equipment, communication, transportation, personnel, flexibility) and a total of thirty-six sub-criteria regarding disaster preparedness. At the same time, FDEMATEL is applied to uncover the interdependence between criteria and sub-criteria. Finally, TOPSIS is used to obtain ranking of hospitals. To provide inputs for TOPSIS implementation, some key performance indicators are established and related data is gathered by the aid of experts from the assessed hospitals. A case study considering 4 hospitals from the Turkish healthcare sector was used to demonstrate the proposed approach. The results evidenced that Personnel is the most important factor (global weight = 0.280) when evaluating the hospital preparedness while Flexibility has the greatest prominence (c + r = 23.09).

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This paper presented a new approach to the calculation of quality-adjusted life years (QALY) based on multi-criteria decision-making (MCDM) methods and using the EQ-5D-5L questionnaire. The health status utility values were calculated through a hybrid methodology. We combined the analytic hierarchy process (AHP), the AHP with a D-number extended fuzzy preference relation (D-AHP), the fuzzy analytic hierarchy process (F-AHP), and the technique for order preference by similarity to the ideal solution (TOPSIS) to obtain individual and aggregated utility values. The preference data were elicited using a sample of individuals from a Colombian university. In all tested methods, the ordinal preferences were consistent, and the weights were compared using the Euclidean distance criterion (EDC). We identified F-AHP-TOPSIS as the optimal method; its benefits were associated with modeling the response options of the EQ-5D in linguistic terms, it gave the best approximation to the initial preferences according to EDC, and it could be used as an alternative to the known prioritization method. This hybrid methodology was particularly useful in certain medical decisions concerned with understanding how a specific person values his or her current health or possible health outcomes from different interventions in small population samples and studies carried out in low- and middle-low-income countries.

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The present work aimed to compare the small, neutral and monoaromatic oxime, isatin-3-oxime (isatin-O), to the commercial ones, pralidoxime (2-PAM) and obidoxime, in a search for a new potential reactivator for acetylcholinesterase (AChE) inhibited by the pesticide paraoxon (AChE/POX) as well as a novel potential scaffold for further synthetic modifications. The multicriteria decision methods (MCDM) allowed the identification of the best docking poses of those molecules inside AChE/POX for further molecular dynamic (MD) studies, while Ellman's modified method enabled in vitro inhibition and reactivation assays. In corroboration with the theoretical studies, our experimental results showed that isatin-O have a reactivation potential capable of overcoming 2-PAM at the initial moments of the assay. Despite not achieving better results than obidoxime, this molecule is promising for being an active neutral oxime with capacity of crossing the blood⁻brain barrier (BBB), to reactivate AChE/POX inside the central and peripheral nervous systems. Moreover, the fact that isatin-O can also act as anticonvulsant makes this molecule a possible multipotent reactivator. Besides, the MCDM method showed to be an accurate method for the selection of the best docking poses generated in the docking studies.

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RESUMO O abastecimento de água e o saneamento são dois serviços essenciais para a sociedade, ainda mais no Brasil, onde há, historicamente, um déficit desses serviços básicos. Além disso, também se sabe que tais serviços envolvem muitos atores, que muitas vezes possuem perspectivas conflitantes, características de problemas multicriteriais. Diante disso, o presente estudo teve como objetivo avaliar o serviço de abastecimento de água de oito municípios do Estado do Rio Grande do Norte (RN). Para tanto, foram selecionados 11 critérios, levando-se em consideração aspectos operacionais, financeiros e de qualidade da água, e foi adotado o método de apoio multicritério à decisão TOPSIS. Também foi utilizado o procedimento da entropia para a obtenção dos pesos de cada critério. Os resultados apontaram o município de Lagoa Nova como a alternativa com melhor serviço de abastecimento de água entre as opções estudadas. Em contrapartida, Santana do Matos foi o município com a pior avaliação do conjunto de alternativas estudadas.

ABSTRACT Water supply and sewage are two essential services to society, especially in Brazil, where historically there has been a deficit of these crucial services. Moreover, it is also known that such services involve many actors who often have conflicting perspectives, characteristics of multicriteria problems. Thus, this paper aimed to evaluate the water supply service in eight cities of Rio Grande do Norte State, Brazil. Eleven criteria were selected, considering operational, financial and water quality aspects. We adopted the TOPSIS method to support the multicriteria decision. In addition, the entropy method was used to obtain the weights for each criterion. The results showed the city of Lagoa Nova as the alternative with the best water supply service of the alternatives studied. In contrast, Santana do Matos was the city with the worst water supply assessment of all the studied alternatives.